Endovascular Repair of Peripheral Arterial Disease

Abstract

<jats:sec><jats:title>Objective</jats:title><jats:p> One thousand consecutive patients who underwent endovascular repair in an 8-year period were studied retrospectively to evaluate technical success, freedom from reinterventions, early clinical outcome, and risk factors for restenosis/occlusion. </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> Mean ± SD Rutherford class was 3.29 ± 0.8. A total of 755 patients have claudication, 423 from rest pain, and 569 from ischemic ulceration. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> A total of 552 men and 448 women (mean ± SD = 69.84 ± 8 years; range = 19–89 years) underwent endovascular repair. A total of 698 patients received local anesthesia and 302 general anesthesia. A total of 447 patients received percutaneous transluminal angioplasty, 650 stents were placed; 231 atherectomies were performed and 171 patients received hybrid approach. The procedure was successful in 847 patients (84%). There was no early death. There were 151 early occlusions (95 underwent surgery, 56 received stents), 121 dissections (39 underwent surgery, 56 received stents and 26 medical treatment), 32 hematoma, and 13 early leaks. Mean ± SD Rutherford class improved to 3.02 ± 0.9. Freedom from reintervention rate at 8 years was 76%. A total of 63 patients underwent surgery and 59 cellular therapy. A total of 134 finger, 142 below-knee, and 29 above-knee amputations were reported. </jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p> Endovascular interventions can be performed with a satisfactory technical success and low complication rates; however, nonfatal complications and catheter-based reinterventions are frequent. </jats:p></jats:sec>

Predictors for the Development of Major Adverse Limb Events after Percutaneous Revascularization—Gender-Related Characteristics

“…The rates of major amputation and the need for reintervention were similar across the two groups, but, as indicated previously, the location of lesions and type of angioplasty in women were somewhat different. Although our research lacked the power to properly support a negative correlation due to its relatively small sample size, our findings are in line with other larger studies, which also failed to show a correlation between gender and MALE over time [ 8 ]. Orr et al investigated 104 angioplasties, and there was no significant difference in the outcomes between men and women [ 17 ].…”

“…A meta-analysis using the National Inpatient Sample (NIS) database concluded that women have similar in-hospital mortality compared to men, who are more likely to develop periprocedural complications such as acute renal failure, gangrene or infections [ 7 ]. Another study published in 2017 describing the mid-term results of endovascular therapy of more than 1000 subjects (45% women) did not identify significant differences related to the subjects’ gender regarding one-year patency of endoprostheses [ 8 ]. Variables such as sex, age, diabetes, hypertension, dyslipidemia, or cerebrovascular disease were not predictors for restenosis or occlusion in the short and medium term.…”